On Friday, Health Minister Peter Dutton opened the door to lifting the long-standing ban on private health insurers paying for GP services, sparking concerns from consumer advocates and health economists that a change could accelerate a shift to a two-tiered health system, where those who can afford private cover receive better care than those who cannot.

The nation's largest health insurer, Medibank Private, has been pushing for the change for several months, arguing that treating medical conditions earlier would reduce the need for more expensive hospital treatment later.

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In November, the company began a trial with medical centre manager IPN in which six of its Brisbane medical centres provide Medibank members with enhanced GP services, including a guaranteed appointment within 24 hours and after hours home visits, for no out-of-pocket costs. Medibank is not paying IPN for the services directly but is contributing to ''administrative and management costs''.

The nation's second-largest health insurer, Bupa, has attacked its rival over the issue, telling Fairfax Media that while allowing insurers to cover GP charges would be popular with health fund members and be ''a boon for healthcare providers'', it could be costly for the government because health fund members might use more services.

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Royal Australian College of General Practitioners president Liz Marles said she was concerned schemes such as the one being trialled by Medibank would encourage people to switch from their regular doctor to another doctor who was affiliated with their health fund.

''The most important thing in getting good outcomes is continuity of care,'' Dr Marles said.

She said the organisation believed access to care should be based on ''medically assessed need'' rather than other factors.

Medibank Private's national medical director, Ian Boyd, said it was up to members in the trial areas to decide whether they wanted to use the enhanced services being offered.

James Gillespie, deputy director of the Menzies Centre for Health Policy at the University of Sydney, said allowing private insurers to pay GP fees risked extending the two-tiered system to primary care.

Brian Morton, chairman of the Australian Medical Association council of general practice, called for a conversation between government, health insurers and the medical profession to ensure that ''short-term gains for Medibank Private'', which the government is preparing to sell, ''don't damage the system for everyone''.